连续115例小儿法乐四联症外科治疗无手术死亡经验  

Surgical treatment of Fallot in children:a report of 115 consecutive cases without mortality

作　　者：刘锦纷[1] 朱宏斌[1] 朱德明[1] 陈玲[1] 苏肇伉[1] 丁文祥[1] 

机构地区：[1]上海第二医科大学新华医院小儿心胸外科,200092

出　　处：《中华胸心血管外科杂志》1999年第5期263-265,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的：总结连续１１５ 例小儿法乐四联症根治术无手术死亡经验。方法：１１５ 例法乐四联症病儿，９ 月龄～１３ 岁，平均（４ ．６ ±２ ．７） 岁，３ 岁以下５５ 例，合并有肺总动脉或一侧肺动脉闭锁４ 例，肺动脉瓣缺如１ 例，合并房间隔缺损和动脉导管未闭１１ 例。全部病儿均施行根治手术，用ｄａｃｒｏｎ 补片修补室间隔缺损，用自体心包作右室流出道及肺动脉扩大，１０２ 例（８９ ％ ） 作了跨瓣环补片。结果：全组无手术死亡。随访２ ～４８ 个月，术后３ 个月１ 例死于心律紊乱，其余均恢复良好。结论：提高小儿法乐四联症根治术成功率的关键是：改进手术方法，彻底解除右室流出道及肺动脉远端梗阻，选用适当的转流技术和重视术后监测。Aim:One surgical team has continuously performed total correction of tetralogy of Fallot(TOF) in 115 patients without surgical mortality.This paper presents the experience in improving the surgical outcome.Clinical material and methods:115 patients with mean age of 4.6 year underwent surgical repair for their TOF.Among them,47.8% were younger than 3 years old.Associated cardiac anomalies included atresia of main pulmonary artery or one-sided pulmonary artery in 4 cases,atrial septal defect and patent ductus arteriosus in 11.All patients underwent total correction.102 cases(89%)needed a transannular patch.Results:There was no hospital mortality.The patients have been followed up from 2 months to 4 years.One child died three months after operation because of cardiac arrythmia.The remaining patients remain well.Conclusion:Improvement of surgical technique,total relief of obstruction of right ventricular outflow tract and distal pulmonary arteries and proper postoperative care are important factors influecing surgical outcome.

关 键 词：法氏四联症 体外循环 外科手术 

分 类 号：R725.411[医药卫生—儿科] R726.542[医药卫生—临床医学]